Osteoporosis

Question 1

Define osteoporosis

Answer 1

decreased bone mass due to disruption of micro-architecture of bone that results in risk of fractures

Question 2

How is bone mineral density measured and what is the threshold for osteoporosis?

Answer 2

DEXA; 2.5 S.D. below peak one mass at 20 y.o.

Question 3

What is the softening of bone?

Answer 3

osteomalacia

Question 4

What is decreasing of bone density?

Answer 4

osteoporosis

Question 5

What is too little bone; low bone mass called?

Answer 5

osteopenia

Question 6

What is primary osteoporosis?

Answer 6

Most common and not related to any underlying cause,

Question 7

What leads to primary osteoporosis? (3)

Answer 7

• postmenopausal
• idiopathic
• senile (>70 y.o.)

Question 8

What is secondary osteoporosis?

Answer 8

osteoporosis associated with other disease or medication.

Question 9

What age can you get secondary osteoporosis?

Answer 9

any age

Question 10

What two hormone deficiency can lead to primary osteop?

Answer 10

estrogen, testoterone

Question 11

What excessive intake can lead to osteop?

Answer 11

vitamin A

Question 12

Prolonged use of what three drugs can lead to secondary osteop?

Answer 12

• corticosteroid
• Heparin
• anticonvulsant

Question 13

What is the most common metabolic bone disease?

Answer 13

osteop

Question 14

What is the top 4 fracture sites due to osteop?

Answer 14

1. vertebral
2. wrist
3. hip
4. pelvic

Question 15

What is the outer portion of the bone called and it makes up for what % of the bone in the body?

Answer 15

cortical; 80%

Question 16

What is the spongy inner portion of the bone called?

Answer 16

trabecular

Question 17

What age does bone mass peak?

Answer 17

25-35

Question 18

What is the bone resorption called?

Answer 18

osteoclasts

Question 19

What is the bone formation called?

Answer 19

osteoblasts

Question 20

How much bone is remodeled annually?

Answer 20

5-10%

Question 21

Where does 80% of bone remodelling occur?

Answer 21

trabecular bone mostly in the vertebrae

Question 22

What are some bone growth stimulators? (3)

Answer 22

Parathyroid hormone
Thyroid hormone
Growth hormone

Question 23

What are 2 inhibitors (hormones) for bone growth?

Answer 23

Adrenal corticosteroid & Calcitonin

Question 24

Female/Males when do they start to loss 1% bone density a year?

Answer 24

women: 30-50
men: 50-55

Question 25

How is bone density diagnosed? 2

Answer 25

X-ray | 24 hour urine collection

Question 26

Where is the Gold Standard for bone mineral density check and the thresholds for diagnosing osteopenia, normal, osteop, and fragility fracture?

Answer 26

``` @ femoral neck normal <1 osteopenia 1-2.5 osteop >2.5 fragility fracture >3.5 ```

Question 27

What is the 1st line drug for prevention & treatment of osteop?

Answer 27

Bisphophonate

Question 28

How does bisphonophonate work to prevent osteop?

Answer 28

decreases bone resorption via osteoclast

Question 29

How does Calcitonin work to prevent osteop?

Answer 29

decreases Ca2+ levels by suppressing osteoclast activity

Question 30

What is a valid fall risk assessment for elderly? (3)

Answer 30

Fall Efficacy Scale and ABC (activity specific balance confidence Scale, Berg Balance Scale

Question 31

For Berg Balance Scale what score is associated with increased fall risk?

Answer 31

Berg Balance Scale score of <45

Question 32

What motions lead to vertebral fractures?

Answer 32

trunk flexion and rotation

Question 33

What are the 3 components of a successful exercise?

Answer 33

site specific overload safe

Question 34

What is the most common acute orthopedic problem in the elderly?

Answer 34

Hip fx

Question 35

What is the mortality rate of hip fx?

Answer 35

2-40%

Question 36

24% of pt over the age of what die in the year of the hip fx?

Answer 36

50 y.o

Question 37

What is type I hip fx?

Answer 37

Post. hip dislocation and fx of head inferior to fovea

Question 38

what is type II hip fx?

Answer 38

Post hip dislocation and fx of head superior to fovea

Question 39

what is type III hip fx?

Answer 39

type I or II with femoral neck fx

Question 40

What is ype IV hip fx?

Answer 40

type I or II with acetabular rim fx

Question 41

What is Garden's Class I hip fracture?

Answer 41

valgus impaction of femoral head, incomplete

Question 42

What is Garden's Class II hip fracture?

Answer 42

Complete but nondisplaced

Question 43

What is Garden's Class III hip fracture?

Answer 43

Complete fracture displaced <50%

Question 44

What is Garden's Class IV hip fracture?

Answer 44

Complete fx displaced >50%